Long-term administration of anticonvulsants is necessary for patients prone to convulsions in order to prevent seizures. However, continuous administration of anticonvulsants can often provoke liver dysfunction and impair cognitive ability. Some Japanese herbal medicines (Kampo formulae) have long been known to inhibit seizures and to have a protective effect on liver function. To elucidate these effects, Kampo formulae (Saikokeishi-to and Shakuyakukanzo-to) were administered to patients with convulsive seizures and liver dysfunction due to cerebrovascular disorders, traumatic brain injury and brain tumors. Administration of anticonvulsant drugs was decreased simultaneously with administration of these Kampo formulae.
The results indicated inhibition of convulsive seizures and a definite recovery of liver function. Improvements were also observed in cognitive function. Based on these findings, it is suggested that Kampo formulae are useful for patients with seizures and/or liver dysfunction, and that the dosage of anticonvulsant drugs may be decreased when Kampo formulae are also being administered.

The problems of breath-by-breath measurement of respiratory gas exchange to analyze the transient responses during complex load work are described and treated. With review for the experimental systems developed by other investigators, our signal transducers and data processing were improved. We found the computer-processed data were in good agreement with those obtained from simultaneous Douglas bag gas collection.
1) Errors in the measurement of volume arose from errors in the flow signals such as nonlinearity, base-line drift, noise, and frequency response, as well as composition and temperature of gas, water vapor condensation, quantization errors, and breathing valve leakage. ±1.74% error in the flow integration reproducibility resulted from the modification of the upstream geometry of the pneumotachometer and the pressure tubing as well as a compensation for base-line drift and filter smoothing.
2) Errors in the gas concentration signals were attributed to inaccuracy, drift, noise, and water vapor concentration. The transport delay of gas concentration signals was overestimated in order to cancel the underestimation in Vco₂and Vo₂·Other compensation methods for the response time were discussed.
3) Error magnitudes below±0.97% in the A/D amplitude quantization were found by means of signal simulation.
4) The optimal compromises between breath recognition threshold and the fluctuation in flow signal were examined to permit identification of irregular breath.
5) Since the breathing valve dead space was modified to tidal volume dependent, errors in the gas exchange variables were reduced.
6) To validate the accuracy of the equipment operation and the gas exchange algorithm, problems in signal simulation and the model lung were described.

In order to study respiratory transients during exercise, we examined breath-by-breath differences between gas exchange kinetics measured at the mouth and those estimated at the alveolar level. The gas exchange data at the mouth were obtained by measurement of expired gases only (expiratory flow method) . Correction for breath-by-breath changes in lung gas stores was applied to the total gas exchange, which was obtained by subtracting expired from inspired gas volume (alveolar gas exchange method) . Constant work loads (150, 200, 250 W) and a ramp work load (30 W/min) preceded and followed by a 50 W load were generated by a computerized cycle ergometer. Best-fit first- or second-order model values for gas exchange kinetic parameters were found by the non-linear least-squares method.
1. Regardless of work intensity and forcing function, the breath-by-breath variation in gas exchange measured at the mouth was larger than the gas exchange estimated at the alveolar level, in both a non-steady state and a steady state. The variation was caused by the invalidity of assuming zero N₂ exchange at the mouth, which was attributed to changes in lung volume.
2. Vo₂ kinetics at the alveolar level were faster than those at the mouth, while the converse held for Vco₂ at the onset of constant load work, due to the effects of fluctuations in lung gas stores on the kinetics of gas exchange at the mouth. During ramp load work, Vo₂ and Vco₂ kinetics at the alveolar level were faster than those at the mouth.
3. Steady state gas exchange values at the alveolar level and at the mouth were the same during constant load work, since the lung gas stores corrections added up to small fractions of the total gas exchange when summed over the long term.
4. Consideration of both the proper end-expiratory lung volume and ventilationperfusion inhomogeneity was required in order to estimate the true alveolar gas exchange.

Laparoscopy-assisted distal gastrectomy (LADG) has been advocated as a minimally invasive operation for early gastric cancer which needs regional lymph node resection. However, since it is technically too complicated and difficult to perform all laparoscopic procedures within the abdominal cavity, LADG has not become the standard surgical procedure for early gastric cancer. Moreover, a skin incision of approximately 5cm is required to allow the reconstruction of the digestive tract after gastrectomy. Therefore, we have developed an operative procedure which we call hand-assisted laparoscopic distal gastrectomy (HALDG). In this procedure we make a skin incision of 6cm, and the surgeon inserts his/her left hand into the abdomen to assist the laparoscopic procedure. The surgeon can move his/her left hand freely, to palpate and explore the organs, as in an open surgery. Therefore, the operation time can be shortened. Our results thus far obtained demonstrated that HALDG was as safe and effective as open distal gastrectomy. HALDG assures the patients a better quality of life, --less surgical trauma, less pain, speedy return to dialy life activities. Thus, it is beneficial to the patients with early gastric cancer. We, therefore, advocate the use of HALDG in such cases.
Gastrectomy ; Stomach Cancer ; Hand ; Procedures ; Pulmonary evaluation

OBJECTIVETo compare the expression profiles of a set of homing-related molecules (HRM) repertoire expressed on hematopoietic stem/progenitor cells (HS/PC) from different sources.

METHODThe expression levels of HRM on HS/PC from umbilical cord blood (UCB), mobilized peripheral blood (mPB) and bone marrow (BM) were assessed using a highly sensitive 4-color flow cytometric analysis.

RESULTSUCB-derived CD34(bright) cells, as well as mPB- and BM-derived CD34(bright) cells strongly expressed CD44, CD11a, CD18, CD62L, CD31 and CD49d. On the other hand, significantly lower expressions of CD49e, CD49f, CXCR-4 and CD54 on UCB-derived CD34(bright) and CD34(bright)CD38(-) cells, compared with those on mPB- and BM-derived CD34(bright) and CD34(bright)CD38(-) cells, were observed. None of UCB-, mPB- and BM-derived CD34(bright) cells expressed other chemokine receptors, including CCR-1, CCR-2, CCR-3, CCR-5, CXCR-1, CXCR-2, CXCR-3 and CXCR-5. Another striking finding was that only mPB-derived CD34(bright) cells expressed significant levels of both the matrix metalloproteinases MMP-2 \[(11.4 +/- 4.9)%\] and MMP-9 \[(27.6 +/- 7.8)%\].

CONCLUSIONHS/PC from UCB have some defects of expression of HRM repertoire, which might partly explain the cause(s) of delayed hematopoietic reconstitution after UCB transplant.

Antigens, CD34 ; immunology ; Bone Marrow Cells ; cytology ; immunology ; metabolism ; CD11a Antigen ; immunology ; CD18 Antigens ; immunology ; Cell Adhesion Molecules ; metabolism ; Cells, Cultured ; Fetal Blood ; cytology ; Flow Cytometry ; Hematopoietic Stem Cell Mobilization ; Hematopoietic Stem Cells ; cytology ; immunology ; metabolism ; Humans ; Hyaluronan Receptors ; immunology ; Infant, Newborn ; Matrix Metalloproteinases, Secreted ; metabolism ; Platelet Endothelial Cell Adhesion Molecule-1 ; immunology ; Receptors, CXCR4 ; metabolism

We reported nine cases of metastatic skin carcinoma experienced at the Department of Dermatology, Obihiro Kosei Hospital during the period from April 1991 to March 1993. Lung was the most common primary lesion (four out of nine cases), followed by uterus (two) and stomach, breast, and kidney (one each). The clinical features of the metastases were classified into nodular (five cases), inflammatory (one case) and sclerotic (three cases) types. Peculiar zoster-like inflammation was seen in metastatic gastric cancer. Pathologically, adenocarcinoma was more common than squamous cell carcinoma. The average interval between the diagnosis of the primary cancers and the development of the skin metastases was about 30±25 months. The average life span after the detection of the skin metastases was 6.8±5.6 months. Poor prognosis of skin metastasis was thus reconfirmed.

STUDY DESIGN: Case series. PURPOSE: To determine the utility of "PainVision" apparatus for the assessment of low back pain. OVERVIEW OF LITERATURE: A newly developed device, the PainVision PS-2100 (Nipro, Osaka, Japan), has been used to assess the perception of pain in a quantitative manner. In the current study, we aimed to evaluate the efficacy of PainVision for the assessment of low back pain. METHODS: We assessed 89 patients with low back pain. The numeric rating scale (NRS) score, McGill Pain Questionnaire (MPQ) score and the degree of pain calculated by PainVision were measured twice at 4-week intervals in each patient. An electrode was patched on the forearm surface of the patients and the degree of pain was automatically calculated (degree of pain=100x[current producing pain comparable with low back pain-current at perception threshold/current at perception threshold]). Correlations between NRS and MPQ scores and the degree of pain were determined using Spearman's rank correlation test. RESULTS: There was a strong correlation between the NRS and MPQ scores at each time point (rs =0.60, p<0.0001). The degree of pain also showed a moderate correlation with NRS and MPQ scores at each time point (rs =0.40, p<0.03). The change in the degree of pain over 4 weeks showed a moderate correlation with changes in the NRS and MPQ scores (rs =0.40, p<0.01). CONCLUSIONS: PainVision as self-reported questionnaires is a useful tool to assess low back pain.
Electrodes ; Forearm ; Humans ; Low Back Pain* ; Pain Measurement ; Surveys and Questionnaires